Clinical Aspect and Prognosis of Stenotrophomonas (Xanthomonas) Maltophilia Keratitis

ABSTRACT

PURPOSE: To investigate the risk factor, clinical manifestations, treatment results, and prognoses in Stenotrophomonas maltophilia keratitis. METHODS: Ten eyes of 10 patients who were diagnosed with, Stenotrophomonas maltophilia by corneal smear and culture were included in this study. Each patient's past history, visual acuity, location and size of ulceration, hypopyon, treatment results and prognosis were analyzed retrospectively. RESULTS: Seven pateints (70.0%) were men, and 3 were women. The mean age was 62.9+/-11.3 years. Only 2 eyes (20.0%) had previous histories of corneal traumas. Polymicrobial infections, including 3 cases infected with Pseudomonas species and 2 cases infected with Fusarium species, were detected in 7 eyes (70.0%). The lesions were located at the corneal center in 6 eyes, and hypopyon was observed in 9 eyes. The average size of ulceration was 28.5+/-19.6 mm2. Seven eyes (70.0%) underwent surgical treatment. The initial visual acuity was less than 0.02 in 9 eyes (90.0%). The final visual acuity improved in 3 eyes (30.0%) and was less than hand movement in 7 eyes (70.0%). CONCLUSIONS: Stenotrophomonas maltophilia keratitis occurs in patients with a compromised ocular surface, is often polymicrobial, and is associated with poor prognoses.